Pieces Missing from the Medicare Benefits Puzzle – 2019

Just like a puzzle with pieces missing, Medicare does not pay all of your medical expenses.

— 2019 Medicare Deductibles / Co-Pays —

Part A: Hospital Deductible (per Benefit Period*)

$1,364

Part A: Hospital Coinsurance, per day (days 61-90)

$341

Part A: Hospital Coinsurance, per lifetime reserve day after day 90 of each benefit period (maximum of 60 lifetime reserve days for ALL benefit periods combined during your lifetime)

$682

Part A: Skilled Nursing Facility Coinsurance, per day (days 21-100)

$170.50

Part B: Monthly Premium (**See Notes below)

$135.50**

Part B: Annual Deductible

$185

*Benefit Period. The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you’re admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven’t received any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There’s no limit to the number of benefit periods each year.

Note #1: Your Part B premium will be based on your modified adjusted gross income. Most people will pay the amount shown in the chart above. But, if you filed an individual tax return for 2017 and your modified adjusted gross income was more than $85,000, your Part B premium for 2019 is shown in the table below. If you filed a joint tax return for 2017 and your modified adjusted gross income was more than $170,000, your Part B premium for 2019 is also shown in the table below. The Social Security Administration will compute your premium for you. However, we suggest that you double-check their computation against your 2017 tax return.

Note #2: “Why does Social Security use my modified adjusted gross income from 2017 to determine my Part B premium for 2019?” Part B premiums for 2019 were announced in mid-November 2018. Instead of guessing what your earnings would be for the full year in 2018, Social Security used the adjusted gross income from your 2017 tax return.

2019 Part B Monthly Premium

If your 2017 income was …

File Individual Tax Return

File Joint Tax Return

File Married & Separate Return

You Pay in 2019

$85,000 or less

$170,000 or less

$85,000 or less

$135.50*

$85,001 to $107,000

$170,001 to $214,000

Not applicable

$189.60*

$107,001 to $133,500

$214,001 to $267,000

Not applicable

$270.90*

$133,501 to $160,000

$267,001 to $320,000

Not applicable

$352.20*

$160,001 to $499,999

$320,001 to $749,999

$85,001 to $414,999

$433.40*

$500,000 and above

$750,000 and above

$415,000 and above

$460.50*

*If you don’t have to pay a late-enrollment penalty.

2019 Part D Monthly Premium Surcharge

Note: Just like your Part B premium, your Part D premium surcharge will be based on your modified adjusted gross income. Most people will pay the amount billed by their insurance company. But, if you filed an individual tax return for 2017 and your modified adjusted gross income was more than $85,000, your Part D premium surcharge for 2019 is shown in the table below. If you filed a joint tax return for 2017 and your modified adjusted gross income was more than $170,000, your Part D premium surcharge for 2019 is also shown in the table below. The Social Security Administration will compute your premium for you. However, we recommend that you double-check their computation against your 2017 tax return.

If your 2017 income was …

File Individual Tax Return

File Joint Tax Return

File Married & Separate Return

Your 2019 Monthly Surcharge

$85,000 or less

$170,000 or less

$85,000 or less

$0*

$85,001 to $107,000

$170,001 to $214,000

Not applicable

$12.40*

$107,001 to $133,500

$214,001 to $267,000

Not applicable

$31.90*

$133,501 to $160,000

$267,001 to $320,000

Not applicable

$51.40*

$160,001 to $499,999

$320,001 to $749,999

$85,001 to $414,999

$70.90*

$500,000 and above

$750,000 and above

$415,000 and above

$77.40*

*If you don’t have to pay a late-enrollment penalty.

We welcome your comments. And, if this post was helpful, please share it with your friends.

About Mike Gamble

Mike is a former family caregiver with a passion for improving the Quality of Life for Older Adults and Family Caregivers.

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Mike Gamble

Mike is a former family caregiver with a passion for improving the Quality of Life for Older Adults and Family Caregivers. Read More…